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Open Versus Minimally Invasive Surgery for Congenital Diaphragmatic Hernia Repair: A Systematic Review and
Emily E Lugard1, Marios Alogakos2, James W F Burns3
1School of Medicine, St George's, University of London, London, UK; Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.
The Journal of Surgical Research
|July 1, 2026
Summary
Minimally invasive surgery (MIS) for congenital diaphragmatic hernia (CDH) shows lower morbidity and mortality but higher recurrence than open surgery (OS). Patient selection for MIS in pediatric CDH needs further research.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes Research
Background:
- Congenital diaphragmatic hernia (CDH) management relies on surgical repair.
- Open surgery (OS) and minimally invasive surgery (MIS) are primary treatment modalities.
Purpose of the Study:
- To compare the safety and efficacy of OS versus MIS for pediatric CDH repair.
Main Methods:
- Systematic review and meta-analysis of 30 studies (6355 patients).
- Searched PubMed, Embase, Cochrane, Web of Science, and Scopus databases.
- Random-effects model used for analysis.
Main Results:
- MIS associated with lower overall morbidity (OR: 0.51), lower mortality (OR: 0.20), and shorter hospital stay (-4.5 days).
- OS associated with lower recurrence rates (OR: 2.09) and shorter operative time (26.8 min).
- Significant heterogeneity observed for operative time and hospital stay.
Conclusions:
- MIS may be considered for pediatric CDH despite higher recurrence rates.
- Optimal patient selection criteria for MIS require further investigation, considering CDH severity and comorbidities.
